Longer-term effectiveness of eLearning and blended delivery of Mental Health First Aid training in the workplace: 2-Year follow-up of a randomised controlled trial.

INTRODUCTION: Evidence relating to long-term outcomes of online education programs is largely lacking and head-to-head comparisons of different delivery formats are very rare. The aims of the study were to test whether eLearning Mental Health First Aid (MHFA) or blended training (eLearning plus face-to-face course delivery), implemented in an Australian public sector workplace, were more effective than a control intervention at 1-year and 2-year follow-up, and whether blended MHFA training was more effective than eLearning alone. MATERIAL AND METHODS: Australian public servants (n = 608 at baseline) were randomly assigned to complete an eLearning MHFA course, a blended MHFA course or Red Cross eLearning Provide First Aid (PFA) (the control) and completed online questionnaires pre- and post-training and one and two years later (n = 289, n = 272, n = 243 at post, 1- and 2-year follow-up respectively). The questionnaires were based on vignettes describing a person with depression or post-traumatic stress disorder (PTSD). Primary outcomes were mental health first aid knowledge, desire for social distance and quality of support provided to a person in the workplace. Secondary outcomes were recognition of mental health problems, beliefs about treatment, helping intentions and confidence, personal stigma, quality of support provided to a person outside the workplace, self-reported professional help seeking and psychological distress. RESULTS: At 1-year follow-up, both eLearning and blended courses produced greater improvements than PFA training in knowledge, confidence and intentions to help a person with depression or PTSD, beliefs about dangerousness and desire for social distance. At 2-year follow-up, some of these improvements were maintained, particularly those relating to knowledge and intentions to help someone with PTSD. When eLearning and blended courses were compared at 1-year follow-up, the blended course led to greater improvements in knowledge and in confidence and intentions to help a person with depression. At 2-year follow-up, improvements in the quality of help provided to a person with a mental health problem outside the workplace were greater in participants in the blended course. CONCLUSIONS: Both blended and eLearning MHFA courses led to significant longer-term improvements in knowledge, attitudes and intentions to help a person with a mental health problem. Blended MHFA training led to an improvement in the quality of helping behaviours and appears to be more effective than online training alone.Trial registrationACTRN12614000623695 registered on 13/06/2014 (prospectively registered).Trial registry record url: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366410&isReview=true.

Effectiveness of eLearning and blended modes of delivery of Mental Health First Aid training in the workplace: randomised controlled trial.

BACKGROUND: The aim of the WorkplaceAid study was to compare the effects of eLearning or blended (eLearning plus face-to-face course delivery) Mental Health First Aid (MHFA) courses on public servants' knowledge, stigmatising attitudes, confidence in providing support and intentions to provide support to a person with depression or post-traumatic stress disorder (PTSD). METHODS: A randomized controlled trial was carried out with 608 Australian public servants. Participants were randomly assigned to complete an eLearning MHFA course, a blended MHFA course or Red Cross eLearning Provide First Aid (PFA) (the control). The effects of the interventions were evaluated using online questionnaires pre- and post-training. The questionnaires centred around vignettes describing a person meeting the criteria for depression or PTSD. Primary outcomes were mental health first aid knowledge and desire for social distance. Secondary outcomes were recognition of mental health problems, beliefs about treatment, helping intentions and confidence and personal stigma. Feedback on the usefulness of the courses was also collected. RESULTS: Both the eLearning MHFA and blended MHFA courses had positive effects compared to PFA eLearning on mental health first aid knowledge, desire for social distance, beliefs about professional treatments, intentions and confidence in helping a person and personal stigma towards a person with depression or PTSD. There were very small non-significant differences between the eLearning MHFA and blended MHFA courses on these outcome measures. However, users were more likely to highly rate the blended MHFA course in terms of usefulness, amount learned and intentions to recommend the course to others. CONCLUSIONS: The blended MHFA course was only minimally more effective than eLearning MHFA in improving knowledge and attitudes. However, course satisfaction ratings were higher from participants in the blended MHFA course, potentially leading to greater benefits in the future. Longer-term follow-up is needed to explore this. TRIAL REGISTRATION: ACTRN12614000623695 registered on 13/06/2015 (prospectively registered).

Providing mental health first aid in the workplace: a Delphi consensus study.

BACKGROUND: Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. METHODS: A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. RESULTS: The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. CONCLUSIONS: The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.

Temperament, family environment and anxiety in preschool children.

This research examines the relationship between behavioural inhibition (BI), family environment (overinvolved and negative parenting, parental anxiety and parent-child attachment) and anxiety in a sample of 202 preschool children. Participants were aged between 3 years 2 months and 4 years 5 months, 101 were male. A thorough methodology was used that incorporated data from multiple observations of behaviour, diagnostic interviews and questionnaire measures. The results showed that children categorised as behaviourally inhibited were significantly more likely to meet criteria for a range of anxiety diagnoses. Furthermore, a wide range of family environment factors, including maternal anxiety, parenting and attachment were significantly associated with BI, with inhibited children more likely to experience adverse family environment factors. No interactions between temperament and family environment were found for child anxiety. However, a significant relationship between current maternal anxiety and child anxiety was found consistently even after controlling for BI. Additionally, there was some evidence of a relationship between maternal negativity and child anxiety, after controlling for BI. The results may suggest that temperament and family environment operate as additive, rather than interactive risk factors for child anxiety. This is discussed in the context of theoretical models of child anxiety and directions for future research.

Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders: a randomized trial.

OBJECTIVE: The current trial examined whether a specific cognitive-behavioral treatment package was more efficacious in treating childhood anxiety disorders than a nonspecific support package. METHOD: One hundred twelve children (aged 7-16 years) with a principal anxiety disorder were randomly allocated to either a group cognitive-behavioral treatment (CBT) program or a control condition (group support and attention [GSA]). RESULTS: Overall, results showed that CBT was significantly more efficacious compared with the GSA condition: 68.6% of children in the CBT condition did not meet diagnostic criteria for their principal anxiety diagnosis at 6-month follow-up compared with 45.5% of the children in the GSA condition. The results of the child- and parent-completed measures indicated that, although mothers of CBT children reported significantly greater treatment gains than mothers of GSA children, children reported similar improvements across conditions. CONCLUSIONS: Specific delivery of cognitive-behavioral skills is more efficacious in the treatment of childhood anxiety than a treatment that includes only nonspecific therapy factors.